Ornaghi S, Maraschini A, Donati S, et al. - Researchers aimed at determining the prevalence of placenta accreta spectrum (PAS) in Italy. In addition, they examined its correlated factors, ante- and intra-partum management, and perinatal outcomes. Furthermore, since severe morbidity and mortality in Italy show a North-South gradient, assessment and comparison of perinatal outcomes of women with PAS was done according to the geographical area of delivery. Using the Italian Obstetric Surveillance System (ItOSS), they identified a cohort of 384 women with PAS from a source population of 458,995 maternities for a prevalence of 0.84/1,000. Analyses by geographical area showed that women in Southern Italy had higher rates of both concomitant placenta previa and prior CS and antenatal suspicion compared with those from Northern Italy. In addition, these women showed lower rates of hemorrhage ≥ 2000 mL, blood transfusion, and severe maternal morbidity. 71.9% of these patients delivered in a referral center for PAS. These findings suggest association of antenatal suspicion of PAS with improved maternal outcomes, also among high-risk women with both placenta previa and prior CS, likely due to their referral to specialized centers for PAS management.